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Recent Advances in Pediatrics (Special Volume 19: Developmental and Behavioral Pediatrics)
Suraj Gupte
1:
Developmental Assessment and the Pediatrician
INTRODUCTION
HISTORICAL ASPECTS
WHY DEVELOPMENTAL SCREENING?11–15
WHO IS THE BEST FOR DEVELOPMENTAL SCREENING: PEDIATRICIAN OR PSYCHOLOGIST?
DEVELOPMENTAL SCREENING AND DEVELOPMENTAL PREDICTION
HARMS AND LIMITATIONS OF THE DEVELOPMENTAL SCREENING
PARENTS' OPINION AS A PRESCREENING DEVELOPMENTAL TEST
2:
Normal Development
GOVERNING PRINCIPLES
DEVELOPMENT OF LOCOMOTION, MANIPULATION, ETC.3–5
Locomotion
Ventral Suspension
Supine Position
Prone Position
Sitting Position
Standing and Walking Position
Additional Forms of Locomotion
MANIPULATION
Hand and Finger Skills
Use of Eyes
Use of Ears
GENERAL UNDERSTANDING (INTERPERSONAL AND SOCIAL SKILLS)
Displeasure and Pleasure
FEEDING/DRESSING
Opening of Mouth
Speech
Bladder Control
Bowel Control
Handedness
3:
Pediatric Psychopharmacology: Recent Controversies
INTRODUCTION
BACKGROUND
THE GROWTH IN PRESCRIPTION OF STIMULANT MEDICATION FOR ADHD—THE US SCENARIO
LESSONS FOR INDIA
ANTIDEPRESSANTS IN CHILDREN: RECENT CONCERNS
INCREASE IN USE OF SSRI IN UK AND USA
TIMELINE OF THE GENESIS OF SSRI DEBATE
CONCLUSION
4:
Somatization Disorders
INTRODUCTION
CLASSIFICATION
DIAGNOSTIC CATEGORIES AND CLINICAL CHARACTERISTICS
PREVALENCE
SPECIFIC SYNDROMES
Pseudoseizures2, 10
Pain Syndromes
Recurrent Abdominal Pain
Prevalence of Psychiatric Illness in Children with Somatization
IMPORTANCE OF RECOGNIZING SOMATIZATION DISORDERS
ETIOLOGY
Predisposing Factors
Family
Child
Precipitating Factors
Child
Family
Maintaining Factors in Child, Parents and Professionals
MANAGEMENT
Evidence Base of Management
Recurrent Abdominal Pain
Headache and Migraine
Dissociative Disorders (Pseudoseizure, Motor Paralysis, etc.)
Principles of Treatment
Engagement Process and Arriving at a Clinical Formulation
WHAT HAPPENS TO THESE CHILDREN WHEN THEY GROW UP?
5:
Eating Disorders
INTRODUCTION
PLANNING TREATMENT PROTOCOL
ANOREXIA NERVOSA
Differential Diagnosis
Laboratory Anomalies
Low Albumin
Treatment
Goals of Nutritional Treatment2
Goals of Psychotherapy
Pharmacotherapy
BULIMIA NERVOSA
Differential Diagnosis
Treatment
6:
Adolescent Depression
INTRODUCTION
EPIDEMIOLOGY
ETIOLOGY
CLINICAL FEATURES
COMORBIDITY
TREATMENT
7:
Attention Deficit Hyperactivity Disorder in Adolescents: Evaluation and Psychological Management
INTRODUCTION
DIAGNOSIS1
Educational Issues
Symptom2,3
Hyperactivity-Impulsivity
Inattention
PSYCHOLOGICAL MANAGEMENT1, 3
Treatment Modalities
Psychotherapy
Psychological vs Psychopharmacological Treatment
SUMMARY
8:
Attention Deficit Hyperactivity Disorder in Adolescent: Psychopharmacology
INTRODUCTION
PSYCHOPHARMACOLOGIC MANAGEMENT
Stimulant Medication
Methylphenidate
MPH Side Effects
MPH Preparations
Amphetamine Products
Prevalence of Stimulant Abuse
Pemoline
NONSTIMULANT MEDICATIONS
Alpha2 Agonists
Clonidine
Guanfacine
ANTIDEPRESSANTS
Tricyclic Antidepressants
Bupropion
Atomoxetine
New and Future ADHD Medications
9:
Childhood Disintegrative Disorder and Rett's Syndrome
INTRODUCTION
DEVELOPMENT OF DIAGNOSTIC CONCEPT
EPIDEMIOLOGY
CLINICAL FEATURES
DIFFERENTIAL DIAGNOSIS
ETIOLOGY
Neurochemistry and Neuropathology
Neurological Aspects
Genetics
Medical Conditions Associated with CDD and RS
ASSESSMENT
Investigations
Developmentally Based Assessments
Behavioral Assessments
Diagnostic Assessments
INTERVENTIONS
Enhancing Language and Communication
Behavioral Interventions
Family Interventions
Rehabilitation
Psychopharmacology
COURSE AND PROGNOSIS
INDIAN DATA
CONCLUSIONS
10:
Autism and Related Disorders: Regression of Milestones
INTRODUCTION
PATTERN OF INFANT DEVELOPMENT
MOTOR AND ADAPTIVE BEHAVIOR
LANGUAGE DEVELOPMENT
PERSONAL AND SOCIAL BEHAVIOR
EMOTIONAL AND AUTONOMIC REGULATIONS
NEUROPLASTICITY
DEFINITION OF AUTISM
BASIC PROBLEMS AND CONSEQUENCES OF AUTISM5
NEUROBIOLOGICAL INSIGHTS INTO AUTISM
Evidence for an Organic Cause
Genetic Factor
Neuroimaging Studies
Neurochemical
Magneto Encephalography
Magnetic Resonance Spectroscopy (MRS)
DIFFERENTIAL DIAGNOSIS
Rett's Syndrome (RS)
Infantile Neuronal Ceroid Lipofuscinosis (INCL)
Fragile X Syndrome
Childhood Disintegrative Disorder
Asperger's Syndrome
Tuberous Sclerosis (TSc)
Hypomelenosis of Ito
Neurocutaneous Syndromes
Metabolic Disorders
William Syndrome (WS)
Angelman's Syndrome
Infections
Epileptic Encephalopathy
WORK UP
PSYCHOSOCIAL ASSESSMENT
Assessment of Development
Ordinal Scale of Infant Psychosocial Development
Baroda Scale
Test of Assessment of Intelligence
Weschler's Primary and Preschool Scale of Intelligence (WPPSI)
Weschler's Intelligence Scale for Children Revised (WISC-R)
Seguin Form Board
Gassel's Screening Test
Adaptive Skills
FUTURE PROSPECT
11:
Obsessive-Compulsive Disorder
INTRODUCTION
PSYCHOLOGICAL IMPACT
INCIDENCE AND PREVALENCE
COMORBIDITY
BEHAVIOR THERAPY
Pharmacotherapy5–8
CONCLUSION
12:
Lead Toxicity and Neurobehavior
INTRODUCTION
HISTORY OF CHILDHOOD LEAD POISONING
EXPOSURES
PATHOPHYSIOLOGY
Absorption
Distribution
Excretion
CLINICAL MANIFESTATIONS
TOXICOLOGY
Neurological Effects
Learning and Memory
Intellectual Functioning
Early Cognitive Development
Behavior
Neurodevelopment
Hematological Effects
Renal Effects
Dental Effects
PRIMARY PREVENTION
Screening
MANAGEMENT
FUTURE ADVANCEMENTS
13:
Epilepsy in the Adolescent
INTRODUCTION
SEIZURES: GENERAL ISSUES
Rolandic Epilepsy
Juvenile Absence Epilepsy
Juvenile Myoclonic Seizure (Juvenile Myoclonic Seizure of Janz)
SEIZURES: SPECIAL ISSUES IN ADOLESCENTS WITH EPILEPSY
Adverse Effects of Antiseizure Drugs
Psychological Aspects
Contraception
Pregnancy
Teratogenicity
Vocational Guidance
Driving
14:
Headaches in the Adolescent
INTRODUCTION
ETIOLOGY
Evaluation
MIGRAINE HEADACHES
Migraine with Aura (Classic Migraine)
Migraine without Aura (Common Migraine)
Atypical and Rare Forms of Migraine and Migraine-like Headaches
Migraine Management
TENSION HEADACHES
15:
The Adolescent with Spina Bifida: Psychological Aspects of Development
INTRODUCTION
BACKGROUND
PHYSICIAN ATTITUDE
LIFE SKILLS AND FAMILY FUNCTION
PARENTAL ISSUES
SELF-CONCEPT
SOCIAL SKILLS AND SOCIAL ISOLATION
DEPRESSION AND SUICIDAL IDEATION
ANXIETY
COGNITIVE FUNCTION
ATTENTION DEFICIT HYPERACTIVITY DISORDER
MEMORY
READING AND WRITING SKILLS
ARITHMETIC SKILLS
VISUO- AND FINE-MOTOR SKILLS
NEUROPSYCHOLOGICAL EVALUATIONS
TRANSITION TO ADULTHOOD
SEXUAL ATTITUDES
SEXUAL MATURITY
SEXUAL FUNCTION
FERTILITY, PREGNANCY, AND COMPLICATIONS
SEXUAL EDUCATION
SUMMARY
16:
Post-Traumatic Stress Disorder
INTRODUCTION
EPIDEMIOLOGY
Biological Factors
Psychological Factors
Social Factors
COMORBIDITY
DIAGNOSIS
DSMIV TR Criteria for PTSD16
Diagnostic criteria for 309.81 Posttraumatic Stress Disorder (Cautionary Statement)
Clinical Features
Re-experiencing the Trauma
Avoidance
Symptoms of Increased Arousal and Hypervigilance
Developmental Considerations in PTSD Diagnosis
COURSE AND PROGNOSIS
PHARMACOTHERAPY
PSYCHOTHERAPY
Trauma Focused Cognitive Behavioral Therapy
Eye Movement Desensitization and Reprocessing (EMDR)
17:
Dyslexia
INTRODUCTION
ETIOLOGY
EPIDEMIOLOGY
CLINICAL MANIFESTATIONS
DIAGNOSIS3–6
History
Physical Examination
MANAGEMENT3,6–9
Action in Early Years
Action in Secondary School
Action in High School and Beyond
18:
Mathematical Disabilities: Developmental Aspects
MANIFESTATIONS
Facts
Details
Procedures
Manipulations
Patterns
Words
Sentences
Images
Logical Processes
Estimations
Concepts
Approaches
Accumulations
Applications
Apprehensions
Affinities
MANAGEMENT OF THE CHILD WITH MATHEMATICS DEFICIENCIES
Evaluation
Intervention Strategy1–5
Changing Attitudes of the Family and the Teachers1,3,5
19:
Behavioral Problems: Overview
INTRODUCTION
ETIOPATHOGENESIS
CLASSIFICATION
COMMONLY ENCOUNTERED BEHAVIORAL PROBLEMS
PICA
Types
Etiology
Etiologic Hypotheses
Nutritional Hypothesis
Cultural Hypothesis
Psychologic Hypothesis
Clinical Features
Risks
Diagnosis
X-Ray Studies
Management
BREATH-HOLDING SPELLS
Etiology
Clinical Features
Diagnosis
Treatment
Prognosis
THUMBSUCKING AND NAILBITING
TEETH GRINDING (BRUXISM)
TICS
RHYTHMIC HEADBANGING/ROCKING
TEMPER TANTRUMS
STUTTERING (STAMMERING)
ENURESIS
Clinical Features
Etiology
Diagnosis
Treatment
Encopresis
School Phobia (School Refusal; School Withdrawal)10
Substance Abuse
Child Abuse and Neglect
Anorexia Nervosa
Sibling Rivalry
Suicidal Tendencies in Adolescents
Adverse Effects of Heavy Television Viewing
Periodic Syndrome
HYSTERIA (CONVERSION REACTION/HYSTERIA)
Common Presentations
Management
Parental Divorce and Child Behavior
BEHAVIORAL ASSESSMENT AND THERAPY
20:
Tic Disorders
INTRODUCTION
EPIDEMIOLOGY
ETIOLOGY
Genetic Factors
Neuroanatomical Theories
Neurochemistry
Neuroimaging
Other Theories
CLINICAL FEATURES
COMORBIDITY
COMPLICATIONS
ASSESSMENT OF CHILD WITH A TIC DISORDER
TREATMENT
Pharmacotherapy
Psychosocial Management
21:
Risk-taking Behavior
INTRODUCTION
NORMAL CHANGES
PREDISPOSING CIRCUMSTANCES
VARIOUS ACTS/BEHAVIOR
Drug Abuse
Sexual Activities
Cyber Sex
Live-in-relationship
Delinquent Acts
“Super Brat Syndrome”
Street Children
Violent Behavior
Terrorism
Accident Proneness
Suicidal Tendencies
Childhood Obesity
IMPACT OF HIGH RISK BEHAVIORS
On Individual
On Family
On Community and Nation
THE ROLE OF
Pediatrician
Parents
Voluntary Organizations
Government
Media
WHAT TO DO
22:
Disruptive Behavior Disorders
INTRODUCTION
HISTORY
THE CONCEPT OF “AGGRESSION”
CLINICAL FEATURES AND CLASSIFICATION
Oppositional Defiant Disorder (ODD)
Clinical Features
Comparison of ICD-10 and DSM-IV
Conduct Disorder (CD)
Clinical Features
Comparison of ICD-10 and DSM-IV
EPIDEMIOLOGY
COMORBIDITY
ADHD
Learning Difficulties
Substance Abuse
Mood Disorders
Anxiety
Somatoform Disorders
ETIOLOGY
Biological Factors
Genetics and Family
Neuroanatomy and Neuropsychology
Neurotransmitters and Neurochemicals
Under Arousal of the Autonomic Nervous System
Others
Functional/Individual Factors
Temperament and Attachment
Reading Problems
Impulsivity and Behavioral Inhibition
Social Cognition
Puberty and Adolescent Development
Psychosocial Factors
Child Rearing Styles/Parenting
Parent-child Interaction
Peer Rejection and Peer Effects
Child Maltreatment/Child Abuse
Socioeconomic Factors
Predisposing Child Characteristics.
ASSESSMENT
TREATMENT
COURSE AND OUTCOME
INDIAN DATA
23:
Anger, Hostility and Aggression Syndrome
INTRODUCTION
DEVELOPMENT OF EMOTIONS
DEFINITION
ETIOLOGY AND PREDISPOSING FACTORS
Genetic
Environmental
Familial
Impact of Media
Sex of the Child
Hormonal Status
Other Factors
SPECTRUM OF SUCH BEHAVIOR
Type A Behavior
Types of Hostility
Intentional Aggression
Physical Aggression
Verbal Aggression
Symbolic Aggression
Interpersonal Coercive Behavior
Aggression with ADHD
Oppositional Defiant Disorder
Conduct Disorders
Extremist Activities/Adult Criminality
Passive-aggressive Behavior
ASSESSMENT AND DIAGNOSIS
APPROACH TO THE CHILD
Psychopharmacological Approach7
24:
Behavior Analysis in Children
INTRODUCTION
CLINICAL ASSESSMENT OF THE CHILD
Distinctive Features of Childhood Psychopathology
Distinctive Aspects of Child Assessment
Context and the Need for Multiple Informants
Special type of Assessment
Parent Interview
Developmental History
Relationship with family and Peer
Interests, Hobbies, Talents and Avocations
ASSESSMENT OF PARENTS
Family Medical and Psychiatric History
CONDUCTING THE ASSESSMENT
PREPARATION OF CHILD
INTERVIEW OF CHILD
Components of the Child Interview
Mental Status Examination
Standardized Assessment Instruments for Children
Structured and Semistructured Interviews19
Rating Scales
Limitations of Structured Measures in Clinical Assessment
PSYCHOLOGICAL AND NEUROPSYCHOLOGICAL ASSESSMENT
Adjunctive Evaluations
Diagnostic Laboratory Tests
Communicating Findings and Recommendations
BEHAVIOR MANAGEMENT TECHNIQUES
Positive Reinforcement
Extinction
Differential Reinforcement
Shaping
Imitation and Instructional Training
Negative Reinforcement
Punishment
Time-out
Response Cost
Overcorrection
Guidelines for the Punishment
Record Keeping and Trouble Shooting
OUTCOME OF BEHAVIOR MANAGEMENT
25:
Play Therapy
INTRODUCTION
PLAY THERAPY RESEARCH
RATIONALE FOR PLAY THERAPY
DIFFERENT FORMS OF PLAY THERAPY5
Non-directive Play Therapy
Directive Play Therapy
Individual Play Therapy
Group Play Therapy
Child Parent RelationshipTherapy (CPRT)
THE PROCESS OF PLAY THERAPY
ROLE OF THERAPIST
PLAY THERAPY METHOD
TOYS AND MATERIALS6
SETTING LIMITS IN PLAY THERAPY4,5
FUTURE TRENDS IN PLAY THERAPY
26:
Developmental Aspects of Self-esteem
INTRODUCTION
SELF-ESTEEM AT DIFFERENT PERIODS OF CHILDHOOD AND ADOLESCENCE
Middle Childhood
Middle Adolescence
Late Adolescent
FACTORS INFLUENCING SELF-ESTEEM2–4
Inborn Temperament
Environments
ATTRIBUTION THEORY OF SELF-ESTEEM
MANIFESTATIONS
REMEDIAL INTERVENTIONS
Responsibility and Contribution
Choices, Decisions and Problem Solving
Encouragement and Positive Feedback
Self-Discipline
Condoning Mistakes and Failures
27:
Child Abuse and Neglect
INTRODUCTION
DEFINITION
TYPES
Physical Abuse
Emotional Abuse
Neglect and Negligent Treatment
Sexual Abuse
PREVALENCE
Physical Abuse Rates
Sexual Abuse Rates
Emotional Abuse and Neglect Rates
PHYSICAL ABUSE10
SEXUAL ABUSE
Understanding Sexual Abuse
Contact Sexual Abuse
Non-contact Sexual Abuse
Child Sexual Abuse and Internet
EMOTIONAL ABUSE
Emotional maltreatment affect negatively on the:
CHILD NEGLECT18
Definition of Neglect
Characteristics of Neglected Children and their Families
Consequences of Neglect
Interventions
RISK AND PROTECTIVE FACTORS FOR CAN22
SUBSTANCE ABUSE AND CAN
LONG-TERM CONSEQUENCES OF CAN28
A. Physical Health Consequences
Shaken Baby Syndrome
Impaired Brain Development
Poor Physical Health
Psychological Consequences
Poor Mental and Emotional Health
Cognitive Difficulties
Social Difficulties
Behavioral Consequences
Difficulties During Adolescence
Juvenile Delinquency and Adult Criminality
Alcohol and Other Drug Abuse
Abusive Behavior
Societal Consequences
Factors Affecting the Consequences of CAN28
Post-traumatic Stress Disorder (PTSD)36
MANAGEMENT (Table 27.7)
Interviewing Victims of Child Abuse
What to do when you find that a child has been abused?
SOME RECOMMENDATIONS
28:
Childhood Injury Control
INTRODUCTION
ACCIDENT VULNERABILITY
RISK FACTORS
Age
Sex
Socioeconomic Status
Environments
Race
ACCIDENT PREVENTION AT HOME3,5
Dangerous Substances and Poisons
Situations like
Falls
PARENT EDUCATION ON ACCIDENT PREVENTION
CHILD EDUCATION ON ACCIDENT PREVENTION
29:
Adoption
INTRODUCTION
WHY ADOPTION
SOURCE OF ADOPTION: RELATIVE OR AGENCY?
ADOPTION LAWS
ADOPTION AND THE PEDIATRICIAN
ASSESSMENT OF FITNESS FOR ADOPTION2–5
History
Developmental Examination
Investigations
Interpretation
POSSIBLE POST ADOPTION CRISIS SITUATIONS4
Sudden Change Crisis
Behavior Crisis
Communication and Identity Crisis
Assimilation Crisis
INDEX
TOC
Index
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